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Aim or Purpose: Arecanut (AN) alkaloid Arecoline (AC) is cytotoxic, genotoxic, mutagenic, induces proinflammatory and oncogenic cytokines. AN users have a high risk of developing Oral Submucous Fibrosis (OSMF) and Oral Cancer. Salivary AC can be measured < 8 hours after AN chewing and is metabolized to Arecaidine (AD). The aim was to determine and compare the salivary concentration of AC and AD in current and past AN users. Materials and Methods: A prospective observational study where consecutive self- reported 80 current AN users (CAN), 80 past AN users (PAN) [consumption/ abstinence from using AN > 1 month respectively] and 30 age and sex matched Controls(C) (never ever users of AN) were recruited after ethical clearance and informed consent. History of any malignancy and systemic condition/ medications that affect salivary flow and composition were exclusion criteria. 2 ml of unstimulated and stimulated whole saliva was collected by spitting method (2-5 minutes), centrifuged, aliquoted and stored at -80°C till further evaluation by liquid chromatography coupled tandem mass spectroscopy (LC-MS-MS) method. Results: The mean levels of AC and AD were significantly higher in CAN as compared to PAN and C (p=0.000) and significantly higher in unstimulated as compared to stimulated saliva (p=0.000). AD was detected in 23.3 % of C. The mean level of AD in unstimulated saliva was significantly higher in PAN as compared to C (p=0.009). Conclusions: Salivary AC detected in both PAN and CAN is a risk factor for OSMF and oral cancer. Salivary AD is better biomarker than AC for validating self -reported AN abstinence.